LOAN APPLICATION

Borrowers and brokers, if you have a loan proposal for us, please either fill out and submit this form or send - by email or fax - an executive summary that includes the following information. Brokers are protected.

Broker's Name
Company
Address
Address 2
Phone
Fax
E-mail

Principal's Name
Company
Address
Address 2
Phone
Fax
E-mail
Loan Amount ($150,000 minimum)

Purpose of Loan
Description of Collateral//Property
As-is Market Value
As-is Disposition Value (90-120 day sale)
As-Improved Market Value (Construction loans only)
As-Improved Disposition Value (Construction loans only)
Existing Debt
Use of Proceeds
Plan for Repayment
How Did You Hear About Us?
Have You Spoken to a Loan Officer at Landmark? Who?